Ghelfi A M, Garavelli F, Passarino F A, Diodati S, Calcaterra M G, Hails E A, Kilstein J G, Galíndez J O, Paciocco M A, Lassus M N
Servicio de Clínica Médica, Hospital Escuela Eva Perón, Santa Fe, Argentina.
Servicio de Clínica Médica, Hospital Escuela Eva Perón, Santa Fe, Argentina.
Hipertens Riesgo Vasc. 2020 Oct-Dec;37(4):152-161. doi: 10.1016/j.hipert.2020.05.003. Epub 2020 Jun 10.
HELLP syndrome (H: hemolysis, EL: elevated liver enzymes and LP: low platelets) is a form of severe preeclampsia (PE). The syndrome can be: complete or incomplete (with three analytical criteria, or only one or two); Class i, ii or iii (according platelets < 50,000; 50,000-100,000 or > 100,000/mm); postpartum or antepartum; with early or late installation (before or after the 34nd week of gestation). We describe and analyze characteristics and evolution observed in hypertensive pregnant patients who developed HELLP.
Retrospective cohort with observation period of two years. It included pregnant hypertensive women who developed HELLP, during the course of their hospitalization in the maternity hospital of our tertiary care hospital.
It included 318 hypertensive pregnant women. We observed 28 HELLP. Maternal age was 25.8 ±7.2 years and gestational age at diagnosis 31 ± 1 week. Hypertension was chronic in 4 and gestational in 24; eight had presented PE in the previous pregnancy. There were 10 complete and 18 incomplete syndromes; according to platelet disease there were 3 Class i, 16 Class ii and 9 Class iii. HELLP was postpartum in 3 and antepartum in 25: 18 early and 7 late. There were 17 patients who required intensive care and 10 developed complications linked to HELLP. No maternal deaths were recorded.
Presentation was variable, exhibiting mostly in gestational hypertension, antepartum and early. Incomplete form and class II thrombocytopenia were more frequent. Maternal complications were frequent but no deaths were observed.
HELLP综合征（H：溶血，EL：肝酶升高，LP：血小板减少）是重度子痫前期（PE）的一种形式。该综合征可分为：完全型或不完全型（具备三项分析标准，或仅一项或两项）；I级、II级或III级（根据血小板计数<50,000；50,000 - 100,000或>100,000/mm）；产后或产前；早发型或晚发型（妊娠34周之前或之后）。我们描述并分析了发生HELLP的高血压孕妇的特征及病情演变。
回顾性队列研究，观察期为两年。研究对象包括在我们三级医疗医院产科住院期间发生HELLP的高血压孕妇。
研究纳入318例高血压孕妇。其中28例发生HELLP。产妇年龄为25.8±7.2岁，诊断时孕周为31±1周。4例为慢性高血压，24例为妊娠期高血压；8例既往妊娠时有子痫前期病史。10例为完全型综合征，18例为不完全型综合征；根据血小板情况，3例为I级，16例为II级，9例为III级。3例HELLP发生在产后，25例发生在产前：18例为早发型，7例为晚发型。17例患者需要重症监护，10例发生了与HELLP相关的并发症。无孕产妇死亡记录。
临床表现多样，主要表现为妊娠期高血压、产前及早发型。不完全型和II级血小板减少更为常见。孕产妇并发症常见，但未观察到死亡病例。
